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An oral fluoropyrimidine agent S-1 induced interstitial lung disease: A case report

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Author(s): Hiromichi Yamane | Masahide Kinugawa | Shigeki Umemura | Yasuhiro Shiote | Kenichiro Kudo | Toshimitsu Suwaki | Haruhito Kamei | Nagio Takigawa | Katsuyuki Kiura

Journal: World Journal of Clinical Oncology
ISSN 2218-4333

Volume: 2;
Issue: 7;
Start page: 299;
Date: 2011;
Original page

Keywords: Corticosteroid therapy | Interstitial lung disease | Pancreatic cancer | S-1

ABSTRACT
A 66-year-old Japanese man with pancreatic cancer received eleven courses of gemcitabine monotherapy. The tumor responded to gemcitabine until metastatic liver tumors progressed. Subsequently, he was treated with S-1, an oral fluoropyrimidine anticancer agent, as salvage chemotherapy. Forty-two days after initiating S-1, he presented with dyspnea and fever. Chest computed tomography showed diffuse interstitial lesions with thickening of the alveolar septa and ground glass opacity. Serum KL-6 level was elevated to 1,230 U/mL and he did not use any other drugs except insulin. Thus, the development of interstitial lung disease (ILD) was considered to be due to S-1. Arterial blood oxygen pressure was 49.6 Torr in spite of oxygen administration (5 L/min). Steroid therapy improved his symptoms and the interstitial shadows on chest radiograph. Although S-1-induced ILD has mostly been reported to be mild, clinicians should be aware that S-1 has the potential to cause fatal ILD.
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